MYCOLab Ai Logo - gold and army green

Traumatic implantation keratitis caused by Schizophyllum commune in Central India

Summary

This report describes two patients in India who developed serious fungal eye infections (keratitis) after corneal injuries. The infection was caused by Schizophyllum commune, a mushroom-like fungus found on decaying wood. Despite aggressive treatment with antifungal medications and surgery, both patients lost vision in their affected eyes. The case highlights how difficult it is to identify and treat this rare fungus.

Background

Fungal keratitis is a severe cause of corneal blindness in tropical and subtropical developing countries, particularly after corneal trauma. Schizophyllum commune is a rare basidiomycete fungus increasingly reported as a cause of mycotic keratitis worldwide, though it remains underreported in India and is challenging to identify.

Objective

To present two cases of traumatic implantation keratitis caused by S. commune in Central India, highlighting the diagnostic challenges, clinical characteristics, and management difficulties associated with this emerging pathogen.

Results

S. commune was identified in both cases showing characteristic morphology with variable thickness hyphae. Case 1 showed monokaryotic stage without clamp connections; Case 2 showed dikaryotic stage with clamp connections and lateral spicules. Despite intensive antifungal treatment with voriconazole/fluconazole and surgical intervention, both patients experienced graft failure and complete loss of vision in affected eyes.

Conclusion

S. commune keratitis presents significant management challenges with poor prognosis even with appropriate antifungal therapy and therapeutic keratoplasty. Timely diagnosis, rapid species identification, and antifungal susceptibility testing are crucial for adequate treatment. The morphological heterogeneity of S. commune stages complicates conventional identification.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report,
  • Source: PMID: 38550852, DOI: 10.1016/j.mmcr.2024.100644
Scroll to Top